Atheroma Flashcards
1
Q
Define atheroma, atherosclerosis, arteriosclerosis
A
Atheroma – The accumulation of intracellular and extracellular lipid in the intima and media of large and medium sized arteries
Atherosclerosis – The thickening and hardening of arterial walls as a consequence of atheroma
Arteriosclerosis – The thickening of the walls of arteries and arterioles, usually as a result of hypertension or diabetes mellitus
2
Q
Describe the micro and macroscopic appearance of atheromas
A
MACRO
- fatty streak
- simple (raised yellow/ white) plaque
- complicated (thrombosis, calcification) plaque
MICRO
- smooth muscle cell proliferation
- foam cell
- extracellular lipid
- fibrosis
- necrosis
- cholesterol clefts
3
Q
Explain some examples of severe atherosclerosis
A
- IHD
- cerebral ischemia (TIA)
- mesenteric ischemia
- PVD
4
Q
What are the risk factors for atheroma formation?
A
- age
- gender
- hyperlipidaemia
- cigarette smoking
- HTN
- DM
- ETOH
- infection
- lack of exercise
- obesity
- oral contraceptives
- stress
5
Q
Describe the unifying hypothesis of atherogenesis
A
- endothelial injury due to raised LDL, toxins, hypertension and haemodynamic stress
- endothelial injury causes platelet adhesion, PDGF release, SMC proliferation, monocyte migration
- foam cells secrete cytokines stimulating more SMC
6
Q
How can you prevent atheroma?
A
- smoking cessation
- dietary changes
- antihypertensives
- manage DM
- statin therapy